Automated external defibrillators and sudden cardiac arrest.

In April 1998, R.R., aged 72 (a man with no prior history of cardiac disease), was leaving his house with two friends to play golf when he suddenly collapsed. One friend initiated CPR, and the other called 911 on his cellular phone. A Chatham police squad arrived within three minutes; the police "first responder" applied a portable automated external defibrillator (AED) to the unresponsive patient. The AED instructed the first responder to push the shock button. Pulse and blood pressure were immediately restored, and the patient was brought to the Overlook Hospital Emergency Room. The patient subsequently awakened, had a cardiac catheterization revealing severe three-vessel coronary artery disease, and then underwent successful coronary artery bypass surgery. Two and a half years later he remained asymptomatic and was seen in the office of his cardiologist for a routine semiannual exam. Later that same day he was scheduled to play golf with the same two friends who had previously saved his life.

Nonsustained polymorphous ventricular tachycardia during amiodarone therapy for atrial fibrillation complicating cardiomyopathy. Management with intravenous magnesium sulfate.

A case is presented in which amiodarone was administered to suppress paroxysmal atrial fibrillation in a patient with an idiopathic cardiomyopathy. Eleven days after initiation of therapy with amiodarone, the patient experienced syncope and was noted to have recurrent episodes of polymorphous ventricular tachycardia. The patient was hospitalized and treated with a bolus as well as continuous infusion of intravenous magnesium sulfate. When the infusion was transiently discontinued, recurrences of polymorphous ventricular tachycardia were noted. The probable proarrhythmic action of amiodarone, although rare, is reviewed along with a discussion of the novel use of intravenous magnesium sulfate therapy.

Psychopathology, hypnotizability, and dissociation.

OBJECTIVE: The purpose of the study was to replicate and extend previous findings regarding the hypnotizability of different clinical groups. METHOD: The authors compared the differential hypnotizability of four psychiatric groups--patients with dissociative disorders (N = 17), schizophrenia (N = 13), mood disorders (N = 13), and anxiety disorders (N = 14)--and one normal group of college students (N = 63). Hypnotizability was assessed by four different measures: the eye roll sign and the induction score of the Hypnotic Induction Profile, the Stanford Hypnotic Susceptibility Scale, Form C, and two self-ratings of hypnotizability. RESULTS: As predicted, dissociative disorder patients had significantly higher hypnotizability scores on all measures than all other groups. Schizophrenic patients, on the other hand, had significantly lower scores than normal subjects on the eye roll sign and induction score but not on the other measures of hypnotizability. Some other unpredicted between-group differences were also found. Nevertheless, despite the between-group differences, the intercorrelations between the various hypnotizability measures within the normal group were very similar to those observed in the combined patient groups. CONCLUSIONS: The findings suggest that routine hypnotizability assessment may be useful in the differential diagnosis of patients with dissociative disorders.

Construct validity of the Dissociative Experiences Scale: II. Its relationship to hypnotizability.

Undergraduates (n = 311) who volunteered to participate in an experiment on "Hypnotizability and Personality" filled out several personality questionnaires (including the Dissociative Experiences Scale; DES), were administered the Harvard Group Scale of Hypnotic Susceptibility (HGSHS), and completed a self-rating of hypnotizability. The DES overall score correlated significantly with the HGSHS summary score (r(309) = .12, p < .05, two-tailed) and with subject's self-rating of hypnotizability (r(309) = .13, p < .05, two-tailed). The magnitude of these correlations was similar to that observed in a previous study (.14 & .18) and is also similar in magnitude to the correlations typically observed between the HGSHS and the Tellegen Absorption Scale. The potential clinical implications of these findings are discussed.

Rorschach indicators of Multiple Personality Disorder.

The increase in reported cases of Multiple Personality Disorder underscores a great need to differentiate clearly this from other psychiatric disorders and from simulation of Multiple Personality Disorder. Two sets of Rorschach signs have been advanced as clinical markers by their developers, namely Barach and also Wagner, Allison, and Wagner. As the Wagner signs are prevalent in much of the research on Rorschach responses in Multiple Personality Disorder, the purpose of the present study was to evaluate these signs using Wagner's administration and the resulting Rorschach protocols of 16 Multiple Personality Disorder patients and 16 psychiatric controls. Analysis indicated that this system was deficient in correctly classifying these 32 protocols. A new marker, the Splitting Response, emerged, however, which was more useful. This response, in combination with at least one Dissociative response, produced an accuracy rate of 94%. These new criteria may be useful aids in the detection of Multiple Personality Disorder from Rorschach protocols. Replication is urged.

Patients reporting ritual abuse in childhood: a clinical syndrome. Report of 37 cases.

Thirty-seven adult dissociative disorder patients who reported ritual abuse in childhood by satanic cults are described. Patients came from a variety of separate clinical settings and geographical locations and reported a number of similar abuses. The most frequently reported types of ritual abuse are outlined, and a clinical syndrome is presented which includes dissociative states with satanic overtones, severe post-traumatic stress disorder, survivor guilt, bizarre self abuse, unusual fears, sexualization of sadistic impulses, indoctrinated beliefs, and substance abuse. Questions relating to issues of reliability, credibility and verifiability are addressed in depth, and the findings and implications are discussed.